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THE S. WEIE MITCHELL OEATION 



S. WEIR MITCHELL 

PHYSICIAN 
MAN OF SCIENCE 
MAN OF LETTERS 
MAN OF AFFAIRS 



BY 
CHARLES W. BURR, M.D. 



Delivered before the College of Physicians of Philadelphia 
November 19. 1919 



PUBLISHED BY THE COLLEGE 
1920 



ST 

v*3 



The Weir Mitchell Oration was established by the College of 
Physicians of Philadelphia in an amendment to the Ordinances and 
By-Laws adopted December 2, 1914: 

"This triennial Oration shall have for its subject the life and work 
of Weir Mitchell in their various aspects, or the relation of the phy- 
sician to public life, or the physician in science and letters, or broad 
considerations of psychiatry and neurology, or surgery and military 
surgery in relation to morbid conditions and wounds and injuries of 
the brain and nervous system, or of scientific research, or medical 
books and libraries, or medical history and biography, and shall be, 
so far as possible, of general as well as professional interest. " 



S. WEIR MITCHELL 

PHYSICIAN, MAN OF SCIENCE, MAN OF LETTERS, 
MAN OF AFFAIRS. 



Though the College founded the Weir Mitchell oration December 
2, 1914, within a few days of five years ago, this is the first address 
given under the terms of the resolution. The explanation of the 
delay is simple. Though the United States for three long, dismal 
years was held back from the performance of its duty by a timorous 
administration, reeking with inefficiency, pretending to be satu- 
rated with idealism, taking advice from idols of the parlor socialists, 
flirting with real socialists, striving to lead the people away from 
their strong and healthy belief in Americanism to the worship of 
the false god Internationalism, and having at its head a President 
who was slow to learn that worse things may come to a country 
than war and that upholding national honor is nobler than main- 
taining a disgraceful peace, individual Americans were doing their 
duty; many Fellows of this College, many men from all parts of 
the country, were already giving themselves up to the great task 
in hand and, for that reason, a speaker could not be had. Men of 
worth were doing, not talking, and even those of us, like myself, 



left at home had little time to think of the dead. The World War 
is over, another has replaced it, has come partly in consequence 
of it, and the curtain of futurity, ever retreating but never rising, 
hides an unending succession of tomorrows. But whatever the 
future may contain for us, we may safely, for a moment, forget 
the present sickness of the world and go back to old habits, one of 
the best of which is the study of the lives of the illustrious dead. 
It was very properly decided that the first oration should be 
devoted to a study of Weir Mitchell himself, and the College has 
conferred upon me the honor of making it. I wish now, at the 
beginning, to thank the Fellows for the opportunity they have 
given me to speak concerning one of the two men who did more to 
influence my intellectual life during my later adolescence than all 
others. To Weir Mitchell and William Osier I owe a debt. These 
two men opened for me, as for many others — rather they showed 
us how to open for ourselves — the gate that bars the way to fruitful 
study, ignorance of scientific method. They had sympathy with 
our desire to learn how to satisfy intellectual curiosity. Above all, 
they taught us the paramount necessity of intellectual honesty. 
I can give no higher praise than this. I purpose to speak of 
Mitchell as physician, man of science, man of letters, man of 
affairs. I do not purpose, nor can it be done in the short time at 
my disposal, to give a detailed biography of the man. Indeed, 
biography, as a rule, is a sorry business, unless written by someone 
who knows the real soul of the man, and then usually favoring 
prejudice prevents clear seeing. I had no such close personal 
relations with Weir Mitchell. I was too much his junior to write his 
biography from my personal knowledge. Of his youth I know 
little, mere shreds and patches of half -remembered stories, and for 
this I am sorry, because early in adolescence there appear signs, 

6 



marks and tokens, had we only the eyes to perceive them and the 
knowledge to comprehend, from which we could prophesy with 
certainty, barring disease and accident, the boy's whole mental 
and moral future. The story of the boyhood of a man like Mitchell, 
written by a real psychologist, a real student of behavior, would 
be a valuable contribution to our slight knowledge of mental 
development in the individual. A thousand such would be of incal- 
culable value. As I have said, I know little of Mitchell's boyhood, 
but when his autobiography is published, in his officially written 
life, there will be revealed how it impressed him years after, when 
he had attained middle life or early old age. Such impressions are 
never accurate. A man sees his boyhood through a mist; it may 
be roseate or somber-hued, but always it is there, the mist of 
memory falsified. One thing is certain, he was not precocious, 
but slowly and steadily grew to maturity, nor did he stop then, 
but continued to grow through the later years. His intellectual 
horizon continued to broaden after the period in which in most 
men the mind is fixed, set, crystallized, brittle. This characteristic, 
as well as endurance, which causes the mind to continue bright, 
active, alert and willing and able to accept new ideas until a very 
advanced age, is, I think, more common among men of affairs, 
doers, than among pure thinkers. Many great statesmen have 
lived long, most great poets die at an earlier age. Those whose 
only ability is to talk do not, for some mysterious reason, as a rule, 
attain great age. In that the gods are kind to us. Mitchell was 
not one of those children who startle by their brilliancy and make 
the wise old family doctor fear for the future, knowing full well 
such brilliancy more often portends a mental smash-up and moral 
degradation in adolescence than fruitful genius. That he was an 
imaginative child there is no doubt. Let me tell a story that 

7 



reveals it. When about seven years old he told his mother he had 
just seen a golden chariot with horses and trappings. She, not 
realizing that he, like all imaginative children, had in very truth 
seen a vision, seen by the physical eye the thing he dreamed of , 
chided him for untruthfulness. He felt the injustice of the charge, 
never forgot the incident, and years later, during his professional 
life, many times warned parents to be careful, when their children 
related such things, not to mistake richness of imagination for 
poverty of the moral sense. 

Mitchell was fortunate in heritage and environment, in nature 
and nurture. The first is the more vital, because good inheritance 
may, and often does — we see it daily — overcome the evil of bad 
environment. He came of a high class, intellectual and scholarly 
family. His father was not only a distinguished physician but a 
man of science. He himself passed all his youth in an atmosphere 
of books, and, as a boy, he had that best education, hearing his 
elders converse on things worth talking of. He was, I am told, a 
bookish boy and early showed a love for poetry. He belonged to 
a generation in which it was the custom to read the Bible, and he 
was unconsciously but profoundly influenced in his literary style, 
years after, by the reading. Of course, today we have progressed 
so far that reading the Bible, like reading history, reading anything 
older than the twentieth century, is regarded as a waste of time. 
Our problems, the moderns tell us, are all new; our world is new; 
old times can teach us naught. But old proverbs continue true, and 
if pride goeth before destruction, ignorance causeth destruction. 

I suspect that environment had a large influence in leading 
Mitchell into medicine. His father, being a physician, could help 
him materially. He had lived all his life in a medical atmosphere, 
and I am inclined to believe that had not these external things 

8 



existed^ his inclination toward literature would have proved 
stronger than that toward science and he would have been purely 
a man of letters . The two have much in common. Art and science 
are not as unlike as they seem: both require of their disciples 
imagination; science demands also compelling curiosity to learn 
causes. Literature is the study of the adventures of the human 
soul; science the study of the adventures of the universe and the 
why of things. At all events, whether it was the pull from within 
or from without that controlled him, after ending his collegiate 
studies at the University of Pennsylvania he entered Jefferson 
Medical College and graduated in 1851. Early in his medical 
career he showed he was being driven by influences within himself 
toward scientific investigation. 

His early professional life was not all beer and skittles; it was a 
period of hard, grinding work and heavy responsibilities. Mr. 
Talcott Williams tells us that, in the autobiography, it is recorded 
"that in the ten years after he began the practice of medicine his 
receipts in practice were only a thousand dollars, and in that year 
he had suddenly thrown upon him the responsibility of caring 
for his father's family and was approaching his own marriage.' ' 
But his nature asserted itself. He was not content to be merely 
an every-day doctor, mechanically, routinely, without mental 
interest, dealing out pills and potions. The scientific instinct 
ruled him. In 1853 he was elected to membership in the Academy 
of Natural Sciences, and two years later was placed upon the 
Library Committee. In 1858 a biological section of the Academy 
was instituted on the petition of Mitchell, Leidy, J. A. Meigs, 
Hammond, Hays and others. At the first meeting Mitchell 
presented the first paper on "Blood Crystals of the Sturgeon." 
Years after, when the whole biological point of view of men of 

9 



science had changed mightily, Mitchell's interest in the subject 
came to the front again, and he furthered the great work of Reichert 
on the crystallography of hemoglobin. He was one of the founders 
of the Pathological Society of Philadelphia, the nursery of men 
of science ever since, for there the young may, unhampered by 
the aged, discuss the newest thing and prove it true or false. The 
first meeting was in 1857, and again he presented the first paper. 
From the time of his graduation until 1863, which was a turning- 
point in his career, for then he assumed charge of an Army Hospital 
for Nervous Diseases, he had written twenty-two scientific papers, 
none of them being clinical, but all in the domain of physiology, 
pharmacology and toxicology. During a part of this time he was 
lecturer upon physiology in the Philadelphia Association for 
Medical Instruction, an organization for extramural teaching. 
He wrote on arrow and ordeal poison and on snake venom, was 
the first to describe the chiasm between the laryngeal nerves in 
turtles and observed the almost total immunity of pigeons against 
opium. The most valuable contribution he made previous to his 
war work was his monograph on the venom of the rattlesnake, 
published in 1860 in the Smithsonian Contributions. In speaking 
of it, Dr. William H. Welch said at the Mitchell memorial meeting, 
held in this hall, that investigation of snake venom held Mitchell's 
attention off and on for a half -century, one of the results, the first 
demonstration by Mitchell and Reichert, in 1883, of the so-called 
toxic albumins, to which class belong not only the snake venoms 
but also certain plant, and especially bacterial poisons, being 
epochal. He further said the later classical researches of Flexner 
and Noguchi owed their inception to the inspiration and support 
of Mitchell, aided by grants from the Carnegie Institution. 
The Civil War gave Mitchell opportunity to study nervous 

10 



diseases on a large scale, and he seized it. He, Moorehouse and 
Keen studied in the military hospital many cases of all kinds of 
injuries of nerves received in battle. The material was such as only 
a great war can give, and he used it for the book, Gunshot Wounds 
and Other Injuries of Nerves, published in 1864. The work brought 
him scientific reputation, because it was a great book and solved 
not a few problems in neurology; in fact, no really important new 
clinical contribution to the symptomatology of disease of the 
peripheral nervous system has been made by anyone since, though 
much has been discovered concerning causation; our point of view 
as to disease in general has greatly changed, and surgical advance 
has tremendously improved treatment. 

Among his minor discoveries were the cremasteric reflex and 
the disease erythromelalgia. His work on the relation of eye- 
strain to headache was of great practical value. In consequence 
of it many a victim of headache, unable to work and suffering from 
intense nervousness, has been relieved. A pair of spectacles has 
even cured a family quarrel and reunited man and wife. Unfor- 
tunately, as often happens, the medical faddist took up the matter 
and claimed to cure all kinds of illnesses by putting on glasses. 
Great harm followed. He studied the eye, not only in its therapeu- 
tic relation, but also was among the first of the American physi- 
cians to point out the great diagnostic importance of ophthalmo- 
scopic examination in studying diseases of the brain. 

His great popular reputation rested on the rest cure. In a little 
book, entitled Fat and Blood, he taught that tired nerves, states of 
nervous irritability, suspiciousness short of real delusions, terrible 
haunting ideas which terrify the victims, can often be cured by 
rest, isolation, massage, milk diet and the rest. He had the glim- 
mering of an idea, which he could never prove, because chemistry 

11 



was not far enough advanced, that milk does good in these patients 
not only because it is easily digested, but because it in some way 
alters the chemistry of the body. The future chemistry will prob- 
ably prove the correctness of his guess. 

There was at first much opposition among physicians to the rest 
cure, especially from those whose temperament compels them 
always to- be in opposition. We all know such people, by sad 
personal acquaintance; they are the type whose mental reflex is 
always "No," and who having once said the word, stubbornly 
persist in their opposition. They are the men who, when St. 
Peter meets them at the gates of Heaven on resurrection day, will 
hesitate, so fixed is their habit of opposition, to accept his kindly 
invitation to enter. Happily, no injury will be done, rather poetic 
justice, for they deserve to go to the other place. Some physicians, 
I fear envy influenced their subconscious minds, said it was unpro- 
fessional for a physician to write in language the common people 
could understand, because it was advertising himself, and he might 
thereby obtain a patient, and to have patients is wicked, because 
it means success. Others, horribly suspicious of the morality of 
their fellows, claimed that massage was immoral. The treatment 
finally, however, became too popular, and incompetent physicians 
used it on patients who needed a work cure, not a rest cure. Never- 
theless, it still has, and will continue to have, a very important and 
useful place in therapeutics. It has brought back to healthy life 
many a nerve- wracked, brain-weary invalid. 

A literary friend, one whose business is book-writing, said, in 

speaking to me about this address, " Of course you will only talk 

about the medical side of Dr. Mitchell's life," his tone implying 

that a mere medico was incompetent to speak on such a great 

matter as literature. In a sense, my friend was right. It would 

12 



be presumptuous for me, a man without technical training, to 
pretend to be a serious critic of modes and methods, and to claim 
to be competent to speak with authority. I disdain to indulge 
in another kind of criticism, or investigation, though a certain 
type of professor of literature, thinking he is very scientific and 
being proud thereof, coDfines his attention to it. I mean the 
man who, lacking the art sense, as some are born color-blind, 
neglects the living soul of literature, dissects its dead body, its 
mere material and studies its mechanism as a mechanic examines 
a machine. This kind of man is illustrated by the teacher who 
gave to one of his post-graduate students in English literature, 
as the subject for her thesis, " The Adjectives of Color and Sound in 
Shelley's Poetry." The dear, innocent seeker after a Doctor of 
Philosophy degree, dug and dug and dug, and catalogued, and wore 
out etymological dictionaries, and thought she was learning litera- 
ture, but failed to see, so plainly was it before her, the very essence 
of the thing. Very soon, instead of finishing her thesis, she became, 
in consequence of her work, my patient; and after rest had cured 
her fatigue, a course in real literature, and I prescribed it, helped 
to make her a healthy woman, with an entirely different notion 
about the study of literature. The professor lost a pupil and a 
school for girls got a very good teacher, who is still without the 
Ph.D. degree. I wish such professors could all be compelled to 
sit at the feet of Quiller Couch, or else become professors of linguis- 
tics, a perfectly proper and useful science, but having nothing to 
do with literature. Again usurping the critic's seat, I had intended, 
in speaking of Mitchell's poetry, to say a few words about what is 
called, in free translation from the French, free verse, but recent 
events make me abstain, because I do not desire still further to 
disturb the already much perturbed emotions of the ladies who are 

13 



carrying on the propaganda in its favor with a somewhat unneces- 
sary violence of verbal and lachrymal effort. May I be permitted 
to say, however, that some of us (Mitchell was of the number) 
enjoy the other forms of poetry more. Mitchell did not use free 
verse, but then he was a minor poet, a poet of occasion, and he 
never rose to those great heights of passion or reached the arcanum 
of philosophy which can only be written about in broken prose. 
Seriously, poetic prose, with a cadence running through it, was not 
discovered only the other day and will continue to be written for 
a long while to come. But may we not ask the present-day leaders 
among the "free versers" to teach the less distinguished practi- 
tioners of the school to realize that thought is of some little value 
in writing, that noise, even musical noise, is not all there is in 
poetry. But, putting aside matters which only a few have a right 
to speak about, there are other aspects than the technical from 
which anyone who reads has a right to judge literature, to be a 
critic, because, after all, men of letters exist to give pleasure to the 
rest of us. They are our servants, not our masters, and we have a 
right to say whether we are pleased or displeased, and why: and 
this is criticism. 

We physicians are prone to boast about the number of our 
fellows who have achieved fame in literature. Really, if we throw 
out the men who studied medicine by accident and soon deserted 
it, the number is surprisingly small. In America, Holmes, who 
really ceased practice early, though he continued to teach anatomy, 
and did it, I am told, charmingly but not ultrascientifically, and 
Mitchell, who practised until the end, are the only two great 
examples, though there have been many minor lights who got 
much pleasure out of letters. The number of American physicians 
possessing the genius for appreciation of literature is large; the 

14 



number endowed with the genius of accomplishment small. This 
is curiously interesting, for if the ability to write were an acquir- 
able faculty, dependent upon favorable circumstances and mere 
technical knowledge of people, the catalogue of men of letters 
would be full of the names of physicians, for no other class has the 
opportunity to see man in his nakedness, his strength and weakness, 
his ability to endure to the end, his frailty from the beginning, 
the play of motives in conduct and the variability of the moral 
sense. Every chief and every assistant in every hospital sees 
daily all the tragedy and not a little of the comedy of human 
behavior, but few perceive. This is the great reason so few medical 
men have attained high rank in literature. Furthermore, physi- 
cians have an unsuspected handicap. Their very knowledge of 
humanity, strange as it at first sight seems, limits them. Almost 
inevitably, when writing, they hold a clinic on good souls or bad; 
they cannot forget they are physicians; they are too painfully 
accurate in detail; they are too learned. Too much technical 
learning is a bad thing in literature. Had Shakespeare been 
learned in the schools he would not have been Shakespeare, but 
Bacon or some other of the same ilk. Mitchell wrote, not because 
his profession gave him large opportunity to study character, 
but because he was born with the faculty to perceive and sympa- 
thetically to understand, apart from professional knowledge, and 
because he had the "urge" to accomplish. It is a great pity that 
more American physicians do not have literary instinct, because, 
even if they never wrote novels, drama or poetry, it would add to 
the interest and hence the value of their professional writings, as 
it did in Mitchell's case. All through the formative period of his 
medical life his professional reading was confined to the writings 
of English, the few Americans who were then writing, and French 

15 



authors. Those men all believed that care in the use of words and 
clarity of expression are important in science; that science should 
be literature. Yesterday, as time counts in the lives of nations, 
we drifted away from such beliefs; tomorrow we may drift back. 
I fear, in any event, we will drift. I cannot hope we will knowingly 
wisely guide our course. The German men of science are largely 
responsible for our fall. One of the evil effects of German influence 
has been to make many of the younger Americans think a slovenly 
style, bad grammar and carelessness in the use of words, prove 
profundity of thought and a mind so active that it cannot be 
orderly. 

I know not whether as a child, he, like so many imaginative 
children, wrote novels and plays to the astonishment of wondering 
parents, who so often think a mere outburst means that out of 
their loins has sprung a genius, only later to see the celestial fire 
burn out and leave behind the dead ashes of a very ordinary mind. 
I suspect he did, but in him the fire burnt on. When he felt the 
first impulse to literature, I also do not know, but he relates the 
following about his first work that brought pay. He says: "I 
never can resist telling a story. While this subject' ' (a discussion 
about amputation stumps) "was occupying my mind, a friend came 
in one evening and in our talk said, 'How much of a man would 
have to be lost in order that he should lose any portion of his sense 
of individuality?' This odd remark haunted me, and after he left 
I sat up most of the night manufacturing my first story, The Case 
of George Dedbw, Related by Himself. In this tale my man had 
lost all four limbs. I left this tale in the hands of a delightful lady, 
now long dead, the sister of Horace Howard Furness. Then I 
forgot it. Dr. Furness, her father, much amused, sent it to Mr. 
Hale, editor of the Atlantic Monthly. To my surprise, I received 

16 



about three months afterward a proof and a welcome check for 
$85, my first literary earning, and certainly not a contribution on 
my part, because I had nothing to do with the disposal of the paper, 
and had not authorized its being put into print. This story has 
had a dreadful number of successors, the product of my lengthening 
summer leisure. Some of them you may have read to your cost. 
The unfortunate George Dedlow's sad account of himself proved so 
convincing that people raised money to help him and visited the 
stump hospital to see him. If I may judge it by one of its effects, 
George Dedlow must have seemed very real. At the close of my 
story, he — a limbless torso — is carried to a spiritualist meeting, 
where the spirits call up his lost legs and he capers about for a 
glorious minute. The spiritualist journals seized on this as a new 
proofof the verity of their belief. Imagine that!" 

He tells us somewhere that Oliver Wendell Holmes advised him 
not to go seriously into literature until his professional position was 
established, telling him if he did it would injure him as a physician, 
because people would say he had lost interest in his medical work. 
It is a curious fact that little-minded people are of fixed opinion 
that no one can have mind enough to do more than one thing. It 
is partly the result of unconscious envy and of the desire to deceive 
themselves into believing that no one can have more ability than 
they possess. The result of Holmes's advice was that Mitchell's 
first novel, Hephzibah Guinness, was not published until 1880. 
He was then fifty years old. 

The medical man, the neurologist, shows little in his novels, 
save in the professional care, the clinical accuracy of description 
of certain bad, really diseased characters. Constance Trescot 
is the one in which most clearly the professional hand of the curer 
of sick minds is evident. The others could have been written — 

17 



I am speaking only of his novels — by a man not a physician. I 
think his talent was for simple stories of common life rather than 
for analyzing the deep complexities of humanity, and this not- 
withstanding the fact that for many years he was busy constantly 
in solving and trying to solve the most complex problems in the 
lives of many people. In Hugh Wynne he reached high-water 
mark. It is no common book, but a real romance, which holds the 
attention of the young, and in the work of attempting to Ameri- 
canize the Americans going on today, much good would result if 
every boy of foreign parentage were given the book to read. 
Every youth would read it with pleasure and get his profit uncon- 
sciously. Such reading would teach true patriotism and would 
overcome much of the unwise psychology and sociology imbibed 
from the silly people who call themselves "the intellectuals." 
After Hugh Wynne I like best When All the Woods Are Green and 
The Adventures of Francois. John Serwood, Iron Master, is a 
remarkable book for any man to write when eighty-one years old. 

Certain of his writings are a connecting link between science and 
literature. His literary instinct, quite as much as his scientific 
curiosity, led him to be interested in a group of subjects which 
are partly medical, but yet appeal to the romantic and poetic side 
of man. Hence, his papers on double personality, sleep and the 
strange things happening then, and the like. Such matters are 
not yet really within the domain of systematized knowledge, 
which is science, but appeal to the love of the mysterious within all 
of us. 

Why has no medical man of letters ever succeeded in depicting 
the physician? None so far as I know has made a great attempt, 
and the lesser efforts have been mere literary thumb-nail sketches. 
I suppose the explanation is that no one can objectify his own class. 

18 



A physician trying to analyze physicians is like a man writing his 
autobiography or painting his own picture looking in a mirror. 
Prejudice makes him see what he wants to see. Mitchell regarded 
George Eliot's "Dr. Lydgate" as the best-described physician in 
modern English literature. I fear he was right. Why I say fear, 
those of you who have read Middlemarch will understand, and if 
any of you are so modern as not to have read it, I advise you to do 
so at once. George Eliot's contemporaries came nowhere near her 
in picturing the physician. Even the great master, Dickens, 
many of whose characters have become types, known everywhere, 
to describe different sorts of men, failed to picture the physician. 
Nowhere on his great canvases, filled to the very edge with men 
and women of so many kinds, does a physician occupy the fore- 
ground. His doctors are either mere caricatures or silly, senti- 
mental, goody-goody men. 

Mitchell had the gift of writing poetry for occasions, and in those 
poems his sense of real humor often appears. The man who can 
hold the attention of the overfed at a banquet while reading verse 
must be a real poet, and Mitchell was always able to do that. As 
pure poetry, I suppose, the "Ode on a Lycian Tomb" is his highest 
attainment. Personally, I like best to read his short descriptive 
poems of outdoors, his descriptions of lakes and rivers, mountains, 
storms and such primitive things. He loved outdoors, and wrote 
lovingly. 

I must pass over his plays, confessing incompetence to judge. 

Weir Mitchell had in smaller degree, and with a smaller stage 
to play on, smaller and fewer opportunities to act, the same zest 
for doing useful things characteristic of Benjamin Franklin. His 
most important public position was that of trustee of the Uni- 
versity of Pennsylvania. He held the position for thirty-five years, 

19 



and retired only when he had attained an age at which most men 
have long before, not only become food for worms, but part of the 
wind-blown and water-carried matter of the world. He had a 
share in the wonderful new birth of the University of Pennsylvania, 
carried on under the guidance of Dr. William Pepper. Though 
he was most active in the committee on the medical school, he was 
much interested in the work of all the departments. During his 
later life he saw the development of that feeling of dissatisfaction 
and unrest shown by teachers of a certain type and ending in the 
organized movement throughout the country for what they called 
the defence of freedom of academic teaching. Really no one in 
America ever thought of restraining the professorial tongue, what- 
ever might be its vaporings, but these misguided gentlemen were 
determined to be martyrs and had a mental twist and very bad 
manners. Mitchell did not take the movement very seriously: 
indeed, did not take it seriously at all. So few people holding 
responsible professorial positions, or, for that matter, minor 
teaching positions, took it seriously, partly, doubtless, because of 
the support it received from the parlor socialists and the sensational 
newspapers, much impotent rage arose within the hearts of the 
pedagogic knights fighting windmills of their own creation. The 
world has had such serious things to think about, and such impor- 
tant things to do in the last few years, and is so busy now saving 
these gentlemen from being hanged at the lamp-post by the real 
bolsheviks, that the movement has died a natural death and has 
not even had the ceremony of a formal burial. I speak of it because 
it was an incident, though a minor one, in the history of collegiate 
education which came somewhat into Mitchell's life. 

He was for many years the guiding spirit of the Orthopaedic 
Hospital and Infirmary for Nervous Diseases. He found it a mere 

20 



dispensary; he left it a large and useful hospital. He studied in his 
clinics there patients who taught him much, and all his assistants, 
who worked with him, had a rare opportunity to learn not only 
medical facts but methods of clinical study: above all, how to 
examine patients. He was always interested in physical therapy, 
and several modes of treatment, such as massage, baths, the use 
of electricity, were introduced to the American profession or 
rescued from the charlatans by him while working there. Even at 
death his influence did not cease, for, through a magnificent gift 
from his long time and deeply devoted friends, Mr. and Mrs. 
Walter G. Ladd, added to by contributions, large and small, from 
people of all ranks in the financial scale, who loved him much and 
who wished to show respect to his memory, the out-patient depart- 
ment was given a well-equipped building of its own, separate and 
apart from the main hospital building. 

He was for years an active member of the Philadelphia Library 
and was a revivifying influence. 

He was the first president of the Franklin Inn, a little club where 
men who love the humanities meet and talk, and used, in the wicked 
pre-prohibition days, even to drink a little — not too much, just 
enough. Originally it was intended for men who live by books, 
authors, and their enemies, the publishers; but once in a while they, 
by gross favoritism, let down the bars and admit to membership 
mere book-lovers. 

Mitchell did more for this College than any other man of his 
day and generation. He was elected to fellowship in 1856, and only 
one Fellow elected in the same year (Dr. J. Cheston Morris) sur- 
vived him. He served as president from 1886 until 1889 and again 
from 1892 until 1895. From the time of his election to fellowship 
until his death his interest in this old society, with its traditions, 

21 



its history, its wonderful library, one of the great medical libraries 
of the world, its sometimes too great conservatism, never flagged. 
His activity in increasing its usefulness was continuous. Through 
his efforts, and at the beginning his alone, were we enabled to leave 
the old barn at the corner of Thirteenth and Locust Streets and 
build this magnificent building. The proposal met with great 
opposition from a small group of timorous, fearsome and somewhat 
obstinate, but well-intentioned fellows, whose sincerity made their 
opposition the more difficult to overcome. Everywhere and always 
there are good men who are temperamentally against all change, 
all progress, all improvement, but I think dear old Philadelphians 
are greater sinners in this respect than any other group of mortals 
anywhere within reach of the sun's rays on this or any other planet. 
The College contained several. They said such a mass of books 
could not be moved, that Twenty-second Street could not be 
reached conveniently, and that we would be bankrupted. When 
Dr. Mitchell induced his friend Mr. Andrew Carnegie to give us a 
very magnificent sum of money for building, they said he was a 
multimillionaire, therefore wicked, and that we would be copartners 
in his sins if we accepted his tainted money Remember all this 
happened at the time the foul-mouthed and vile-natured "muck- 
rakers" were in the ascendant throughout the country and had led 
honest and well-meaning but unintelligent people to have a false 
viewpoint about good morals. Finally, however, Mitchell over- 
came all opposition, and the result is a monument to his diplomacy, 
his untiring industry and his farsightedness. 

Mitchell was from the first interested in the movement for 
instituting schools for training nurses. In his early medical life 
religious sisters were the only women who knew anything about 
nursing, and they, of course, had no systematic training. In most 

22 



hospitals the work was done by orderlies, often drunken, or by 
incompetent women. He had a large part in changing things and 
starting schools for nurses, until now some of us fear that possibly 
nurses may sometimes imagine they know more than doctors. 
Indeed, patients sometimes quote to me the medical opinions of 
nurses, but since, according to the new philosophy, no one is to 
have authority on any matter, especially not the specially trained, 
and no one is to be subordinate but everybody equal, this is to be 
expected. 

One of the most important public questions he was interested 
in was animal experimentation. For years he fought to protect 
mankind from the assaults of fanatics. Some years ago a move- 
ment was started to protect animals from cruelty. It was an 
admirable idea and received well-deserved sympathy and encour- 
agement. But soon men and women of a certain twist of mind 
came to regard animals as having rights equal if not superior to 
men and women. Becoming obsessed with the idea that physicians 
in general, and physiologists in particular, were by nature cruel, 
they soon determined to stop all experiments on animals. I 
should have stated first that sometime previous to this, very 
rapid increase in interest in physiology had begun and that this 
science depends fundamentally on animal experimentation. The 
antivivisectionists, as they call themselves, would have none of it, 
and becoming a well-organized and wealthy body have continued 
a crusade to stop all use of animals in scientific study. In addi- 
tion to the zoophilists, that large body of people, the intelligent 
public, who use as their life proverb, "Where there is smoke there 
must be fire," which though true in physics is not true in life, 
accepted the untruthful statements of the crusaders and increased 
the difficulty of having things done wisely. Mitchell and other 

23 



men tried reasoning with these people. It was shown that thou- 
sands of children were snatched from death by the antitoxin treat- 
ment of diphtheria, the discovery and development of which 
depended wholly upon animal experiment. It was no use. The 
reply was, the doctors were lying about the results, and some dis- 
ciples of the cult even said that it is wrong to kill a dog or other 
animal even if thereby human lives are saved. Veterinary physi- 
ologists showed that animal experimentation saved the lives of 
thousands of cattle, sheep and pigs. The reply was the same, 
"It is wrong to experiment on animals." How long it will be 
before the matter is settled no man knows, but fanaticism never 
finally wins. Historians of the distant future, however, when man 
has become a reasoning animal, will read with interest tinged with 
pity the emotional statements of the zoophilists. Meanwhile, 
knowledge is delayed and mankind and animalkind alike suffer. 
There is hope that the tremendous good resulting from animal 
experimentation, as shown by the medical experience of the war 
just over, the young lives saved, the agonies of pain escaped, 
may so influence public opinion that eccentric people will have 
little influence on politicians, most of whom have had sons or 
brothers or themselves have been in the war. They have seen and 
have lived the realities of life. They will act accordingly. 

He was a director of the Real Estate Trust Company, and when 
through the dishonesty of a trusted official that institution came 
to wreck, he, as was natural, acted the gentleman's part according 
to the gentleman's code. 

Dr. Mitchell's industry was prodigious. Think of the variety 
of his vocations and avocations ! His practice was very large, and 
one requiring not only much thought but also much diplomacy. 
Prescribing medicine was the smaller and, of course, the easier 

24 



part. Teaching people how to live was the more important, 
required more skill and was the more difficult, because many 
patients want physicians to give them a physic which will, in some 
mysterious way, enable them to break nature's laws without 
paying nature's debt, not realizing nature is an inexorable task- 
mistress. It is true that for many years before his death he took 
long holidays from professional work, but earlier there was a long 
stretch of years when holidays were few and short. Physicians 
consider themselves very busy and very unusual if they do only 
this one thing — acquire a large and lucrative practice. But in his 
life it was only a part. In addition to private practice he, through- 
out his life, was a hospital physician. To him, as to every wise 
physician, the hospital was a post-graduate school, where he was 
always taking new courses. He spent a great deal of time in the 
work of the numerous public bodies he was a member of. Hours 
that most men spend in pure idleness or in silly kinds of amuse- 
ment, he passed in scientific or other work. Time left over in this 
busy life he gave to literature, his works numbering upward of 
twenty-five titles, of which fifteen were longer or shorter novels. 
There are many whose sole business is literature, the sum of whose 
work is not larger. Finally, with all this work, he found time to 
play, to get out in the woods and fish, in a real way commune with 
nature, and to enjoy the society of men and women. Indeed, he 
found a great deal of time for social life, for he was instinctively 
a social animal and very gregarious. He was not one of those 
silent, brooding thinkers who live alone and within themselves, and 
then give to a surprised world their work, but a man requiring 
human companionship. 

One secret of his having accomplished so much was very simple. 
He early learned the lesson that the mind is best rested not by doing 

25 



nothing but by changing its occupation. Of course, everyone 
cannot take this prescription, for there are many whose minds are 
so little that they cannot find a multitude of interests, and hence 
can only rest by idleness; but many have large areas of mind, 
unknown to themselves, which could be worked productively if 
only a chance were given. Few men, even among those to whom 
nature has given the best mental machine, work unintermittently 
to full capacity. Some geniuses are able to do creative work only 
in irregularly recurring periods, the rest of the time doing nothing. 
We little people are all prone to follow the law of the labor union 
in mental work and only do as much, usually it is as little, as we 
must. 

Destiny prevented Dr. Mitchell from becoming a teacher. This 
was a misfortune, not to him, but to the young men who studied 
medicine in Philadelphia during his working life, because it so 
greatly restricted his opportunity for personally influencing 
younger men. No man was kinder to young men whom he thought 
worthy of kindness. He was a mental stimulant to every young 
man of intelligent ambition with whom he came in contact. He 
awakened intellectual industry, encouraged ambition and was 
helpful in all the ways that youth needs help. Now, as things 
were, the only young medical men who met him were his own 
assistants and the young instructors in the medical school. Had 
he been a teacher, and hence thrown with hundreds of young men, 
the lives of many would have been altered, not only for their own 
good, but for the betterment of the world. 

Mitchell belonged to the mid-Victorian period, much abused 
today by the disciples of the new philosophy, by the people who 
think the world has changed, and who flatter themselves that they 
have had a large influence in making the leopard change its spots. 

26 



They may have whitewashed it : some of us think they are black- 
washing it, but hope the first storm, the storm about to burst upon 
us now, will clean the wash off. His racial inheritance was British: 
his intellectual environment Victorian. He was influenced in 
literature by Wordsworth and Tennyson, and in some degree by 
Browning, by Scott and Thackeray and Dickens; in science by 
Darwin and the rationalistic naturalists; in medicine by that great 
group of English and French physicians who founded modern 
clinical medicine, who laid such stress on morbid anatomy and 
who founded rational therapeutics. Classical literature and thought 
played little part in his development. 

He had all the terrible vices of the Victorians, those monstrous 
qualities that make the "uplifter," himself going, with a speed he 
knows not of, straight to the world's waste-basket of discarded 
notions, whine with impotent rage whenever he hears them spoken 
of. He did not believe in the racial and mental equality of men. 
He did not believe that all men can take education. He believed 
in democracy, the democracy of our fathers, whose wisdom founded 
representative government, but not in the rule of Demos. He dis- 
trusted Demos for its lack of intelligence, its emotionalism, its 
childish trust in every loud-mouthed political mountebank who 
pays himself high wages in good coin, and his follower, in promises 
bright as the rainbow and as unsubstantial; and because of its 
blood-lust, when its passions are aroused by those who call them- 
selves the people's friends. He believed in government by law and 
not by men, by duly elected assemblies and not by momentary 
noisy heroes. He did not often talk on things political, but I 
remember well his deep, but quietly expressed, emotion, when that 
chief of wordmongers, W. J. Bryan, ran for President: he who 
afterward, for our sins, was visited upon us as Secretary of State 

27 



and settled affairs of great pith and moment in his intervals of 
leisure from his more serious work of appearing on the Chautauqua 
circuit between the yodlers and the fiddlers. 

He was fond of the forms and ceremonies of social life. It was 
he, for example, who was primarily responsible for the use of these 
not very comfortable gowns inflicted on the officers at the meetings 
of this society. He even believed that young people should say 
" Sir" to their elders, and I must confess, to my shame be it spoken, 
that when I was a man in middle life I called him "Sir" spon- 
taneously, unconsciously, reflexly. But then my reflexes were 
firmly fixed before the new freedom was thought of; when we poor 
slaves, unconscious of our slavery, were taught, and believed the 
lesson, that he most respects himself who respects others. 

He, like so many of the Victorians, indeed we find the quality 
rather common in all ages, realized his own worth and was very 
proud of it. Indeed, the little-minded dwellers in a one dimen- 
sional universe, those little souls who pass their lives within an 
intellectual world encompassed by the boundaries of a point and 
have no conception of a larger world without, leading their selfish, 
useless lives and denying the existence of a great outside world, 
inhabited by larger minds, accused him, when they could find no 
other fault, with vanity. In truth he was vain. I will go further, 
he was very vain. But it was a vanity that injured no man, in no 
way lessened his acts of kindness to others, in no way limited his 
good works. If the mental monads, his critics, had done one- 
tenth his work we would have forgiven them ten times his vanity. 

A story told relates how another man had to confess sharing 
possession of this vice when speaking of Mitchell's vanity. Mr. 
Carnegie and Professor Blank were paying Mitchell a visit. 
Mitchell had been talking about himself, and when he left the 

28 



room for a minute Mr. Carnegie said, "He's got a pretty good 
opinion of himself. " Whereupon the other, with a quizzing look 
and speaking slowly, said, "Do not you think that most men who 
do things think well of themselves ?" Then Carnegie, after a 
moment, "Yes, I guess we do. Anyhow it is a human failing." 
It is the most human failing, and not to be counted against men 
who do things, but only against those who do naught in life but 
hunt for faults in their betters. 

A story that Sir William, then Dr. Osier, told at the great 
banquet in New York given in his honor just before he left this 
country to go to Oxford, illustrates the importance of things 
social, of knowledge of how to behave, from the point of view of a 
Victorian. "Now," said Osier, "the authorities of the University 
of Pennsylvania, when they were considering my name for the 
professorship of clinical medicine, were easily able to find out 
about my intelligence, my learning and such things. But they, 
being wise men, wanted to know what manner of man I was: 
was I 'to the manner born?' They solved it thus. Dr. Mitchell 
gave me a luncheon. For dessert there was cherry pie, and, 
remember this, for it is the point, the pie contained the stones. 
The question was : Did I know what to do with the stones? I did." 
Ladies and gentlemen, the examination was more important than 
shows on the face of it. 

The importance of manners from the point of view of the Vic- 
torians is well illustrated in an incident in my own life in which 
Mitchell had a part. When I was a very young man, he sent me 
one day to examine a patient for him. I, being modest, bashful, 
shy, was rather overawed when he told me that the patient was a 
very important old lady, rather irascible, very formal, and that I 
must remember my manners and make a good impression, because 

29 



if I did she could and would be of great professional assistance to 
me; whereas if I offended her, she would forever use her tongue to 
my injury. After this sermon I was pretty well scared and 
approached her trembling within, blushing without, and with 
stammering speech. Her greeting was not cordial. At first I 
thought she was vexed that having sent for the great man his 
jackal had come. Soon I felt it was more personal than that, 
that it was something in me had annoyed her. I went home crest- 
fallen and sad. Next day, when I reported to Dr. Mitchell, be met 
me with the glimmer of a smile, and handing me a letter said, 
"Burr, read that." It ran: "Dear Silas! Never send that young 
man, reeking with tobacco smoke, to see me again." I stopped 
daytime smoking. The incident had a real Sunday-school-story 
ending. A year later I met the old lady socially and told her what 
a good turn she had done me. We became friends and she blew 
my horn until her death. 

He did not believe that the man behind the gun is of any im- 
portance compared with the man who plans the gun. He believed 
in personalities and was himself a personality. He, being old- 
fashioned, did not believe in the identity of the sexes, and so far 
from believing in their equality, failed completely to comprehend 
how, under the mathematics of the new psychology, unlike things 
can be measured by the same units. This, of course, is a trifling 
detail we have gotten rid of by the simple process of putting it to 
one side. His opinion on the woman question is shown in the 
following quotation: 

"What I shall have to say in these pages will trench but little 
on the mooted ground of the differences between men and women. 
I take women as they are to my experience. For me the grave 
significance of sexual difference controls the whole question, and, 

30 



if I say little of it in words, I cannot exclude it from my thought 
of them and their difficulties. The woman's desire to be on a 
level of competition with man and to assume his duties is, I am 
sure, making mischief, for it is my belief that no length of genera- 
tions of change in her education and modes of activity will ever 
really alter characteristics. She is physiologically other than the 
man. I am concerned with her now as she is, only desiring to help 
her in my small way to be in wiser and more healthful fashion 
what I believe her Maker meant her to be, and to teach her how 
not to be that with which physiological construction and the 
strong ordeals of her sexual life threaten her as no contingencies 
of man's career threaten in like measure or like number the feeblest 
of the masculine sex." This is science, wisdom and, of course, 
therefore, truth. 

Mitchell never retired from active life. He was spared that 
long period of partial physical death which sometimes precedes 
mental death : he was spared the very much more horrible and dis- 
tressing thing that is the fate of many men, a long prodromal time 
of mental decay preceding the last blow of all which gives a tardy 
release from living. He endured to the end : his final illness was 
short. He almost had the thing all men should pray for, instead 
of praying to be spared from, a sudden death. The words he used 
in his address at the Centennial Celebration of this College in 1887 
are appropriate to himself. He said: "As earnestly as our first 
President, I pray with him that all who sit around me, and all 
who are to come, do publicly and privately serve their generation." 
He, with great ability leading to great results, served his gen- 
eration. 



31 




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